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General NPI Number Information
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NPI Number | 1942388210
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Entity Type | Organization
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Legal Business Name | GOLDBERG & MARCUS DENTAL ASSOCIATES PC
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Dates
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Enumeration Date | 11/02/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 1825 BARNUM AVE STE 303
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City | STRATFORD
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State | CT
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Zip | 06614
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Country | US
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Telephone | 203-375-6090
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Fax | 203-378-0762
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Provider Business Mailing Address
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Address Line | 1825 BARNUM AVE STE 303
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City | STRATFORD
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State | CT
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Zip | 06614
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Country | US
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Telephone | 203-375-6090
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Fax | 203-378-0762
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Authorized Official
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Title or Position | DENTIST OWNER PRESIDENT
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Name | DR. ALAN GOLDBERG
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Credential | DDS
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Telephone | 203-375-6090
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number |
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License Number State |
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